Evaluating the Hierarchy of Rating Scale Categories for the Coma Recovery Scale-Revised in Non-Traumatic Brain Injury: A Rasch Analysis

The CRS-R demonstrated strong reproducibility and validity in patients with non-traumatic brain injury, but may require refinement due to disordered thresholds. Consistent with literature in traumatic brain injury, our findings suggest that diagnostic criteria may need to be revised to better align with the constellation of behavioral features that are actually observed at different levels of neurorecovery. Specifically, RSC 4 on Auditory (consistent command following) and 3 on Arousal (Attention) may indicate emergence from the minimally conscious state.